Provider Demographics
NPI:1043309933
Name:MOHAMMED, SHAHEEN K (MD)
Entity type:Individual
Prefix:DR
First Name:SHAHEEN
Middle Name:K
Last Name:MOHAMMED
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2313 STONEBRIDGE DR
Mailing Address - Street 2:
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48532-5407
Mailing Address - Country:US
Mailing Address - Phone:810-771-5849
Mailing Address - Fax:
Practice Address - Street 1:2313 STONEBRIDGE DR
Practice Address - Street 2:
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48532-5407
Practice Address - Country:US
Practice Address - Phone:810-771-5849
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-11
Last Update Date:2022-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301063556207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1053513184OtherGROUP NPI
MIG63709Medicare UPIN